Actinic Keratosis - Causes, Treatment & Pictures

 Actinic Keratosis- a rough, scaly patch on the skin


Actinic keratosis (AK) is a common precancerous condition that develops on skin that has been damaged by UV radiation from the sun or indoor tanning. Another name for the disorder is solar keratosis. These precancerous skin growths are frequent because many people do not wear sunscreen or proper protective clothing to protect their skin from the sun. The sun's UV rays can damage your skin in the long run if you don't use sunscreen. While your body may be able to repair some of the damage, the repetitive exposure accumulates over time and might lead to precancerous changes in your skin. 

Actinic keratosis is most commonly found on skin that has been severely sunburned. As a result, they frequently show up on the face, ears, balding scalp, hands, neck, and lips. These are the places that get the most sun exposure. Actinic cheilitis is the medical term for precancerous skin lesions that occur on the lips. Actinic keratosis and actinic cheilitis affect a large number of otherwise healthy people; they don't appear to be sick or tired.

Knowing if you have any of these precancerous growths on your skin is crucial. Keeping an eye on your skin can aid in the detection of precancerous development. If left untreated, actinic keratoses have a 0.6 % chance of developing into squamous cell carcinoma, a kind of skin cancer. 

These rough, scaly spots, known as keratoses, are most common in people with fair skin, blond or red hair, and blue or green eyes. A history of sunburn adds to the danger. These patches can progress to a more serious form of skin cancer if not treated, however, this is uncommon. 

Actinic Keratosis- Causes

Actinic Keratosis on and around the face

Solar keratosis is the common name for actinic keratosis. This word refers to overexposure to ultraviolet (UV) light, which is the cause of skin lesions. Unlike sunburn, which occurs immediately after exposure to UV light, actinic keratosis develops over years of repetitive sun exposure.

Understanding the risk factors and the causes of Actinic Keratosis can help you avoid developing the disease. Being aware of your level of risk will also aid in the early detection of Actinic Keratoses when they are most treatable. The following factors increase your risk:

  • Exposure to sunlight: Prolonged and cumulative exposure to Ultraviolet (UV) light from the sun or indoor tanning without protection can be one of the reasons for developing AK. People who work outdoors under the sun, those who have a bald scalp or thinning hair, and those who have had sunburns are all at risk.

  • Geographic location: If you reside near the equator, you have a higher chance of developing Actinic Keratosis due to higher UV radiation.

  • Low immunity: Weakened immune system due to a medical condition or medication will make you more susceptible to Actinic Keratosis. 

  • Lighter Skin tone: While Actinic Keratosis can affect anyone, they are significantly more common in persons who have fair skin.

  • Advancing age: People over the age of 40 are more likely to develop AK.

  • Male gender: AK is more common among men than women.

How to Spot Actinic Keratosis?

Small dry, scaly, or crusty patches of skin are common symptoms of AKs. They are sometimes elevated and are mostly red, light, or dark tan, but can also be white, pink, flesh-toned, or a mixture of hues. Actinic keratoses are generally easier to feel than see because of their rough texture. Typically, these patches are the size of a small pencil eraser. Itching or burning may occur in the affected area. Lesions might spontaneously heal, they may expand, stay the same, or rarely, they may evolve into squamous cell carcinoma (SCC) over time. It's almost impossible to predict which lesions may turn malignant.

The appearance of Actinic Keratoses varies. The following are some of the signs and symptoms:

  • A rough, dry, or scaly patch of skin with a diameter of less than 0.5cm.

  • On the top layer of skin, there is a slightly elevated area where scales may be present.

  • A rough, warty surface can appear in some circumstances.

  • Pink, red, and brown are some of the colors they may present. 

  • Itching, burning, bleeding, or crusting are all symptoms that can occur with it.

  • Sun-exposed parts of the head, face, neck, hands, and forearms are commonly involved.

How to diagnose Actinic Keratosis?

Be on the alert for any odd changes in your skin if you have a history of unprotected UV exposure, reside in a sunny environment, or have other risk factors. A person will often notice the little patch of skin that grows as a result of this condition. A person should see their doctor as soon as possible if they see any changes to their skin or develop more new bumps. This will assist to diagnose the condition early.

A certified dermatologist will diagnose you if you have one or more AKs on your skin by looking at them closely. Your dermatologist will check for symptoms of skin cancer while inspecting your skin. People with UV-damaged skin develop AKs and are more likely to develop skin cancer. Your dermatologist will discuss whether or not to treat these skin growths and their propensity to develop into cancer in the long run. Treatment is usually suggested. For a few people, a dermatologist may prescribe periodic skin checks rather than treatment. 



Actinic Keratosis- Types of Treatments

The treatment that is best for you is determined by several factors, including:

  • How many Actinic Keratosis lesions do you have?

  • The location of the AK(s) on your body

  • The appearance of Actinic Keratosis lesions

  • Have you been diagnosed with skin cancer or not?

  • Other medical conditions you may have, such as having a transplanted organ.

Woman opting for OTC remedies


Home Remedies

Your dermatologist may suggest at-home treatment if you have multiple scaly patches or actinic keratoses that are difficult to discern. Typically, at-home treatment is using medicinal creams on your skin, as indicated. These creams may need to be used for up to four months. The benefit of utilizing medication to treat your AKs is that it can treat a wide range of AKs, including some you can't see yet. This method can lower your chances of getting new AKs and possibly skin cancer.

The drawback of using medication for your skin is that some patients report that sticking to the treatment regimen is tough. You must apply the drug as often as your dermatologist suggests for it to be effective. You must continue to apply the drug even if it generates a skin reaction, which signals that it is working.

Treating Actinic Keratosis using home remedies will be a slow process and requires patience. Listed below are some of the popular home remedies: 

Apple cider vinegar: Apple cider vinegar has some incredible health benefits. Some individuals drink it to lose weight, while women who bloat during their periods take it to thin their blood. Most crucially, skin problems such as ringworms can be cured by applying apple cider vinegar to the affected area.

How to use: All you have to do is dab a little piece of cotton on the affected region after dipping it in apple cider vinegar. Do this procedure several times a day and night for two or three months. 


Virgin coconut oil: This is the treatment that will put your patience to the test, but it is painless and relieves itching and redness. However, make sure to choose organic virgin coconut oil; it may be a bit more expensive, but it will be well worth it.

How to use: Simply dip your fingers in the coconut oil and apply it to the affected region, then wash your hands. Repeat this process as needed throughout the day. It is claimed to be the most effective treatment for Actinic Keratosis on the face.


Tea tree oil: It will not be wrong to term tea tree oil as a miraculous oil as it has been claimed to treat skin cancer, but only the early stages of malignant skin illnesses.

How to use: Simply dip your fingers in the oil and apply to the affected area, then wash your hands afterward. This process can be repeated several times each day as the oil has a pleasant aroma.


Green tea: Many people have claimed the benefits of using green tea. Green tea extract includes compounds that slow the progression of Actinic Keratosis.

How to use: Simply soak a green tea bag in warm water, then apply the wet bag to the skin and keep it on until all the water has evaporated. Repeat this procedure as many times as you can during the day.

Disclaimer: Though many people claim that using various natural medicines has helped them in healing Actinic Keratosis, there is no validation that these remedies will be a definite success. Before trying any of these remedies, do consult with your dermatologist.


Topical Treatment

Following are some of the most common topical agents that dermatologists usually prescribe in the case of a small or fewer lesion:

5-fluorouracil (5-FU) cream: Topical 5% fluorouracil has been used with great success in the management of individual AKs while also benefiting the field. Localized skin reactions and allergic contact dermatitis are very common side effects due to the strong nature of this agent. 

Note: This is not a suitable therapy choice for a pregnant lady. 5-FU has the potential to harm an unborn child.

Diclofenac sodium 3% gel: This is an NSAID and has a lower risk of causing a skin reaction than 5-FU, but it is still effective. It should be used twice a day for 2 to 3 months. 

Imiquimod 5% cream: This is a fantastic alternative for the face because it only needs to be applied once (or twice) a week, avoiding irritation, But it can still cause erythema, edema, erosion, or scaling. You may have to use it for 12 to 16 weeks for complete clearance of the lesions.

Ingenol mebutate: Ingenol mebutate is a topical therapy in a concentration of 0.015% once daily for 2 consecutive days on the face and scalp, and 0.05% once daily for 3 consecutive days on the trunk and extremities. It is safe and has mild side effects like erythema, flaking, and scaling.


Systemic and Procedural Treatment

Dermatologists use a variety of techniques to treat large and multiple AKs, including:

  • Chemical peel: Chemical peels may reduce the size and appearance of AK but they might reappear later. Medium-depth chemical peels, such as 35%–70% trichloroacetic acid, alpha-hydroxy acids 70%, and phenol 88% are commonly used by dermatologists for AK. The treated region may be painful and red for the first few days. You'll notice a fresh, healthy layer of skin evolving as the wound heals after multiple sessions.

  • Photodynamic therapy: Your dermatologist may offer photodynamic therapy if you have multiple AKs or AKs that reappear after treatment. Photodynamic therapy utilizes a topical photosensitizing agent that is applied to the tumor and followed by exposure to a specific wavelength of light. This is highly effective but can cause severe pain and burning. 

  • Excision: Your healthcare professional will numb the skin surrounding your AKs before performing this procedure. The AKs are then scraped away or cut out, and the region is stitched back together. Your wound will usually heal in two weeks. But this is rarely done for AK. 

  • Cryosurgery: Your dermatologist freezes the AK during cryosurgery. After a few days, the idea is for the AK to fall off. Before falling off, some AKs require more than one cryosurgery treatment session. Your dermatologist will use a very cold chemical such as liquid nitrogen to freeze the AK. You may notice crusting or a blister on your treated skin after cryosurgery. This is very normal and to be expected.

  • Laser: Laser resurfacing with full-face ultra pulse CO2 laser or erbium: YAG lasers can be used to treat AKs. A major disadvantage is the post-procedure healing time. 

How to prevent Actinic Keratosis?

It's critical to take the following precautions to avoid actinic keratosis:

  • Avoid direct sunlight during peak hours of the day (10:00 a.m. to 2:00 p.m.).

  • Cover your arms and legs with light-colored cotton clothing.

  • Apply sunscreen with a sun protection factor (SPF) of 30 or higher, 30 minutes before stepping out in the sun.

  • Avoid the use of tanning beds as its UV exposure can cause just as much skin damage as a tan obtained from the sun.

  • When outdoors during peak sunlight hours, wear a hat with a brim of at least 2 inches wide that shields the ears (not just a cap) or carry an umbrella.

  • Even on cloudy days, reapply sunscreen every two hours when you're outside.

  • If you're sweating, reapply sunscreen more frequently than every two hours, especially soon after getting out of the water. Use a water-resistant sunscreen that lasts at least 40 minutes.

  • Nicotinamide (vitamin B3) 500mg taken twice daily for 12 months decreases the risk of these skin cancers.

  • Consult your dermatologist, who will be able to accurately diagnose the lesion and provide a treatment plan. It's best to catch AKs early and treat them before they get malignant. This is particularly true for AKs that develop on the head or neck, where skin malignancies are more aggressive.

  • Remember that it is the sun's light, not the heat, that is damaging, thus you could be in danger even if the temperature is low.

Concluding note

Actinic Keratosis is a dangerous skin condition that necessitates rapid medical attention. The majority of AKs respond to surgical or topical therapy. By protecting your skin from the sun and ultraviolet light, you can reduce your chances of developing actinic keratosis.

If you suspect you have AK, talk to your dermatologist about a diagnosis and treatment plan. You are less likely to develop skin cancer if you get treatment for Actinic Keratosis as soon as possible. 

SkyMD dermatologists are available to help you by video call or chat, whatever you prefer. A prior booking appointment is not required for your visit to SkyMD. Visit our app, fill in the relevant information, and connect with one of our certified dermatologists.

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